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Es (HCS), Texas Home Living (TxHmL) and Deaf Blind with Multiple Disabilities (DBMD) Programs Note: This form must be faxed to Waiver Survey and Certification by the end of the next business day following the death or the program provider s learning of the death. To: Waiver Survey and Certification Attn: Risk Assessment Coordinators Fax No.: 512-438-4148 Provider Name Contract No. Date Submitted to DADS Comp Code (HCS & TxHmL) Submitted by Area Code and Telephone No. Contact Area Code.

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How to fill out the Form 8493 online

This guide provides a comprehensive walkthrough for users on how to fill out the Form 8493 online. The form serves as a notification to the Texas Department of Aging and Disability Services regarding a death in specific community-based services programs.

Follow the steps to complete the form effectively.

  1. Click 'Get Form' button to obtain the form and open it in the editor for completion.
  2. In the first section, provide the name of the provider and their contract number. Ensure all details are accurate to avoid delays in processing.
  3. Enter the date the form is submitted to DADS. This should reflect the actual submission date to ensure timely communication.
  4. Complete the 'Comp Code' field for HCS & TxHmL programs as applicable, ensuring it aligns with departmental requirements.
  5. Fill in the submitted by section, listing the contact name, area code, telephone number, as well as fax number as needed.

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